Objective: To determine whether high weight for length at the 18-month well-baby visit is predictive of overweight or obese body mass index (BMI) at the 4- to 6-year well-child visit.
Design: Retrospective cohort study using objective electronic medical record measurements.
Setting: Eighteen family practices forming a community family health organization in Peterborough, Ont.
Participants: All children from the family health organization practices with at least 1 set of weight and length or height measurements at age 17 to 19 months and age 4 to 6 years (N=126).
Main Outcome Measure: Relative risk (RR) of overweight BMI and RR of obese BMI at 4 to 6 years of age for normal versus overweight or obese 18-month-olds.
Results: Children who were either overweight or obese at their 18-month visits (n=37) were more than twice as likely to be obese at age 4 to 6 years than children who had healthy weights at 18 months were (n=89; RR=2.71, 95% CI 1.13 to 6.47). The subgroup of obese 18-month-olds (n=13) were at more than 3 times the risk of being obese at age 4 to 6 years than their healthy-weight-for-length counterparts (RR=3.42, 95% CI 1.20 to 9.78). Thirty-one percent of obese 18-month-olds were obese at 4 to 6 years and a further 31% were overweight.
Conclusion: High weight for length at 18 months substantially increased a child's risk of being overweight or obese at 4 to 6 years of age. Most overweight and obese 18-month-olds in this study did not achieve healthy BMIs by 4 to 6 years of age. A brief glance at the 18-month weight-for-length chart can easily help identify these high-risk toddlers.
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